High clarithromycin and levofloxacin resistance in Helicobacter Pylori strains isolated from patients in our high-volume academic endoscopic centre

Background: The antibiotic susceptibility is the cornerstone for the eradication strategies of Helicobacter pylori (H. pylori). Aims: To investigate the prevalence of primary antibiotic resistance of H. pylori in our academic centre. Methods: H. pylori isolates were obtained from consecutive patients submitted to gastroscopy for the evaluation of upper gastrointestinal symptoms. Biopsies from antrum and corpus were taken to determine the antibiotic susceptibility of H. pylori isolates. The minimal inhibitory concentration for amoxicillin, tetracycline, clarithromycin, metronidazole, rifabutin and levofloxacin were determined with the E-test. Results: Ninety patients were included in the study. In vitro antimicrobial susceptibility of H. pylori strains were obtained from 33% (30/90) of patients (11 men, 19 females, mean age 54 years, range 32–73 years). There was no observed resistance to amoxicillin and tetracycline. Resistance to clarithromycin was detected in 33%, to levofloxacin in 27%, to metronidazole in 17% and to rifabutin in 3% of patients. Conclusion: We demonstrate high clarithromycin and levofloxacin resistance rates in our high-volume academic endoscopic centre. Our preliminary data are in accordance with the data in literature, confirming that clarithromycin and levofloxacin resistance is a major challenge for the eradication of H. pylori infection.